Rare Disease Conditions Eligibility Criteria V1.6.0

Total Page:16

File Type:pdf, Size:1020Kb

Rare Disease Conditions Eligibility Criteria V1.6.0 Rare Disease Conditions Eligibility Criteria v1.6.0 Document Record ID Key Work stream Rare Diseases Programme Director Mark Caulfield Status Final Document Owner Richard Scott Version 1.0 Document Author Andrew Devereau, Richard Scott Version Date 16/12/2016 Ellen Thomas Document History The controlled copy of this document is maintained in the Genomics England internal document management system. Any copies of this document held outside of that system, in whatever format (for example, paper, email attachment), are considered to have passed out of control and should be checked for currency and validity. This document is uncontrolled when printed. Version History Version Date Description 0.1 14/12/2016 First draft from RC2 v1.6 catalogue 0.2 14/12/2016 Upgraded after review by Richard Scott 1.0 16/12/2016 Moved to 1.0 for distribution to NHSE Reviewers This document must be reviewed by the following: Name Title Version Richard Scott Clinical Lead for Rare Disease 0.1 Approvers This document must be approved by the following: Name Responsibility Date Version Tom Fowler Director of Public Health 16/12/16 1.0 on behalf of Mark Caulfield Chief Scientist RARE DISEASE CONDITIONS ELIGIBILITY CRITERIA | v1.6.0 1 Contents Quick links page ................................................................................................................................................................ 12 Introduction ...................................................................................................................................................................... 13 Purpose of this document ............................................................................................................................................. 13 Structure and background to eligibility statements ...................................................................................................... 13 Changes since the last release ...................................................................................................................................... 14 Rare Disease Conditions Eligibility Criteria ........................................................................................................................ 19 Cardiovascular disorders (10950) .................................................................................................................................. 19 Arteriopathies (33332) ............................................................................................................................................. 19 Familial cerebral small vessel disease (36469) ......................................................................................... 19 Familial Hypercholesterolaemia (33666) ................................................................................................... 21 Severe hypertriglyceridaemia (42185) ...................................................................................................... 23 Connective Tissues Disorders and Aortopathies (10951) ....................................................................................... 25 Familial Thoracic Aortic Aneurysm Disease (11021) ............................................................................... 25 Cardiac arrhythmia (10952) ..................................................................................................................................... 27 Brugada syndrome (11022) .......................................................................................................................... 27 Long QT syndrome (11023) ........................................................................................................................... 29 Catecholaminergic Polymorphic Ventricular Tachycardia (11024) ................................................. 31 Unexplained sudden death in the young (38566) ................................................................................. 33 Idiopathic ventricular fibrillation (42161) ................................................................................................... 35 Cardiomyopathy (10953) ......................................................................................................................................... 37 Arrhythmogenic Right Ventricular Cardiomyopathy (11025) ............................................................. 37 Left Ventricular Noncompaction Cardiomyopathy (15044) ............................................................... 39 Dilated Cardiomyopathy (31340) ............................................................................................................... 41 Dilated Cardiomyopathy and conduction defects (11027) ............................................................... 43 Hypertrophic Cardiomyopathy (11028) .................................................................................................... 45 Congenital heart disease (10954) ........................................................................................................................... 47 Familial congenital heart disease (42212) ................................................................................................ 47 Syndromic congenital heart disease (42213) .......................................................................................... 49 Lymphatic disorders (33334) ................................................................................................................................... 50 RARE DISEASE CONDITIONS ELIGIBILITY CRITERIA | v1.6.0 2 Meige disease (34328) ................................................................................................................................... 50 Milroy disease (37604) .................................................................................................................................... 52 Lymphoedema distichiasis (37612) ............................................................................................................. 53 Ciliopathies (10963) ...................................................................................................................................................... 54 Congenital malformations caused by ciliopathies (15091) .................................................................................... 54 Bardet-Biedl Syndrome (11046) ................................................................................................................... 54 Joubert syndrome (36478) ............................................................................................................................ 56 Rare multisystem ciliopathy disorders (36488) ......................................................................................... 57 Respiratory ciliopathies (15092) .............................................................................................................................. 59 Primary ciliary dyskinesia (11047)................................................................................................................. 59 Non-CF bronchiectasis (11048) .................................................................................................................... 61 Dermatological disorders (10956) ................................................................................................................................. 63 Atopy (15084) ........................................................................................................................................................... 63 Severe multi-system atopic disease with high IgE (15085) ................................................................... 63 Autoimmune skin disorders (33336) ....................................................................................................................... 65 Generalised pustular psoriasis (33646) ....................................................................................................... 65 Ectodermal dysplasias (33338)................................................................................................................................ 66 Ectodermal dysplasia without a known gene mutation (33699) ....................................................... 66 Ichthyoses (33340) .................................................................................................................................................. 67 Autosomal recessive congenital ichthyosis (33700) .............................................................................. 67 Keratodermas (33342) ............................................................................................................................................. 69 Palmoplantar keratoderma and erythrokeratodermas (33701) ........................................................ 69 Familial disseminated superficial actinic porokeratosis (37644) ......................................................... 71 Neurocutaneous disorders (33344) ........................................................................................................................ 72 Undiagnosed neurocutaneous disorders (33686) .................................................................................. 72 Skin adnexa disorders (36587) ................................................................................................................................ 74 Familial cicatricial alopecia (36588) .........................................................................................................
Recommended publications
  • Partial Rhombencephalosynapsis and Chiari II Malformation
    CASE REPORT SMY Wan PL Khong Partial rhombencephalosynapsis and P Ip Chiari II malformation GC Ooi !"#$%&'(ff !"#$%&'() ○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○ We report a rare case of partial rhombencephalosynapsis coexistent with Chiari II malformation in a 6-year-old girl and discuss the fea- tures of these entities on magnetic resonance imaging. !"#S !"#$%&'()*+,-./0ff !" !"#$%&'()*+,-./01234(5%678 Introduction Rhombencephalosynapsis (RS) is a rare congenital malformation of the posterior cranial fossa characterised by vermal agenesis or hypogenesis and fusion of the cerebellar hemispheres. About 40 cases have been re- ported.1 Partial RS was reported for the first time recently whereby normal development of the anterior vermis and nodulus was noted but part of the posterior vermis was deficient.2 One case of RS associated with Chiari II malformation has also been reported.3 To the best of our knowledge, the coexistence of partial RS and Chiari II malformation and their features on magnetic resonance imaging (MRI) have not been reported. Key words: Case report Arnold-Chiari malformation; Cerebellum; A 6-year-old girl had spina bifida and hydrocephalus at birth. She was the Child; second child of a non-consanguineous southern Chinese couple. Antenatal Magnetic resonance imaging; examination by a private obstetrician including an ultrasound scan at 22 Rhombencephalon weeks’ gestation was reported to be normal. There was no family history of congenital malformations or any other remarkable medical problems. ! Her birth at full term was complicated by her large head and the delivery !"#$%&'() necessitated a Caesarean section. A ruptured myelomeningocele over the lumbosacral region was also noted at birth and there was paucity of lower limb movement.
    [Show full text]
  • Approach to Brain Malformations
    Approach to Brain Malformations A General Imaging Approach to Brain CSF spaces. This is the basis for development of the Dandy- Malformations Walker malformation; it requires abnormal development of the cerebellum itself and of the overlying leptomeninges. Whenever an infant or child is referred for imaging because of Looking at the midline image also gives an idea of the relative either seizures or delayed development, the possibility of a head size through assessment of the craniofacial ratio. In the brain malformation should be carefully investigated. If the normal neonate, the ratio of the cranial vault to the face on child appears dysmorphic in any way (low-set ears, abnormal midline images is 5:1 or 6:1. By 2 years, it should be 2.5:1, and facies, hypotelorism), the likelihood of an underlying brain by 10 years, it should be about 1.5:1. malformation is even higher, but a normal appearance is no guarantee of a normal brain. In all such cases, imaging should After looking at the midline, evaluate the brain from outside be geared toward showing a structural abnormality. The to inside. Start with the cerebral cortex. Is the thickness imaging sequences should maximize contrast between gray normal (2-3 mm)? If it is too thick, think of pachygyria or matter and white matter, have high spatial resolution, and be polymicrogyria. Is the cortical white matter junction smooth or acquired as volumetric data whenever possible so that images irregular? If it is irregular, think of polymicrogyria or Brain: Pathology-Based Diagnoses can be reformatted in any plane or as a surface rendering.
    [Show full text]
  • The Genetic Heterogeneity of Brachydactyly Type A1: Identifying the Molecular Pathways
    The genetic heterogeneity of brachydactyly type A1: Identifying the molecular pathways Lemuel Jean Racacho Thesis submitted to the Faculty of Graduate Studies and Postdoctoral Studies in partial fulfillment of the requirements for the Doctorate in Philosophy degree in Biochemistry Specialization in Human and Molecular Genetics Department of Biochemistry, Microbiology and Immunology Faculty of Medicine University of Ottawa © Lemuel Jean Racacho, Ottawa, Canada, 2015 Abstract Brachydactyly type A1 (BDA1) is a rare autosomal dominant trait characterized by the shortening of the middle phalanges of digits 2-5 and of the proximal phalange of digit 1 in both hands and feet. Many of the brachymesophalangies including BDA1 have been associated with genetic perturbations along the BMP-SMAD signaling pathway. The goal of this thesis is to identify the molecular pathways that are associated with the BDA1 phenotype through the genetic assessment of BDA1-affected families. We identified four missense mutations that are clustered with other reported BDA1 mutations in the central region of the N-terminal signaling peptide of IHH. We also identified a missense mutation in GDF5 cosegregating with a semi-dominant form of BDA1. In two families we reported two novel BDA1-associated sequence variants in BMPR1B, the gene which codes for the receptor of GDF5. In 2002, we reported a BDA1 trait linked to chromosome 5p13.3 in a Canadian kindred (BDA1B; MIM %607004) but we did not discover a BDA1-causal variant in any of the protein coding genes within the 2.8 Mb critical region. To provide a higher sensitivity of detection, we performed a targeted enrichment of the BDA1B locus followed by high-throughput sequencing.
    [Show full text]
  • Pushing the Limits of Prenatal Ultrasound: a Case of Dorsal Dermal Sinus Associated with an Overt Arnold–Chiari Malformation and a 3Q Duplication
    reproductive medicine Case Report Pushing the Limits of Prenatal Ultrasound: A Case of Dorsal Dermal Sinus Associated with an Overt Arnold–Chiari Malformation and a 3q Duplication Olivier Leroij 1, Lennart Van der Veeken 2,*, Bettina Blaumeiser 3 and Katrien Janssens 3 1 Faculty of Medicine, University of Antwerp, 2610 Wilrijk, Belgium; [email protected] 2 Department of Obstetrics and Gynaecology, University Hospital Antwerp, 2650 Edegem, Belgium 3 Department of Medical Genetics, University Hospital and University of Antwerp, 2650 Edegem, Belgium; [email protected] (B.B.); [email protected] (K.J.) * Correspondence: [email protected] Abstract: We present a case of a fetus with cranial abnormalities typical of open spina bifida but with an intact spine shown on both ultrasound and fetal MRI. Expert ultrasound examination revealed a very small tract between the spine and the skin, and a postmortem examination confirmed the diagnosis of a dorsal dermal sinus. Genetic analysis found a mosaic 3q23q27 duplication in the form of a marker chromosome. This case emphasizes that meticulous prenatal ultrasound examination has the potential to diagnose even closed subtypes of neural tube defects. Furthermore, with cerebral anomalies suggesting a spina bifida, other imaging techniques together with genetic tests and measurement of alpha-fetoprotein in the amniotic fluid should be performed. Citation: Leroij, O.; Van der Veeken, Keywords: dorsal dermal sinus; Arnold–Chiari anomaly; 3q23q27 duplication; mosaic; marker chro- L.; Blaumeiser, B.; Janssens, K. mosome Pushing the Limits of Prenatal Ultrasound: A Case of Dorsal Dermal Sinus Associated with an Overt Arnold–Chiari Malformation and a 3q 1.
    [Show full text]
  • Rhombencephalosynapsis: CT and MRI Findings
    Short Reports Rhombencephalosynapsis: CT and MRI findings J. L. F. Mendonça,1,2 M. R. C. Natal,1,2 S. L. Viana,3,4 P. P. A. Coimbra,2,5 M. A. C. B. Viana,2 M. Matsumine 3 1Hospital Santa Lucia; 2Fundaçao Hospitalar do Distrito Federal; 3Clinica Radiologica Vila Rica; 4Unimed Brasilia; 5Hospital Universitario de Brasilia (UnB), Brasilia, DF - Brazil. performed. CT scan, retrospectively analyzed with the benefit of MRI An unusual disorder of cerebellar development, images showed a small fourth ventricle, associated with the absence of rhombencephalosynapsis is a unique entity which presents the septum pellucidum and a small hypodense lesion at the quadrigemi- with cerebellar fusion and absence of cerebellar vermis on nal plate cistern, slightly left to the midline. Fusion of the cerebellar imaging studies, often associated with supratentorial find- lobes was hard to see on CT scan images (Figures 1a and 1b). ings. No specific clinical syndrome has been described in these patients so far, and most cases are found in infancy and childhood. MRI and its multiplanar capabilities and high spatial and contrast resolution increased its recognition. Two cases are reported, with emphasis on imaging findings. Key Words: Rhombencephalosynapsis, Magnetic reso- nance imaging, Computed tomography, Cerebellum, Cer- ebellar malformations. Introduction Rhombencephalosynapsis (RS) is an uncommon malforma- tion of the posterior fossa characterized by hypoplasia or apla- sia of the vermis and fused cerebellar hemispheres; fusion or 1a apposition of the dentate nuclei and cerebellar peduncles are also observed. The clinical course is variable and depends on the severity of the posterior fossa findings and supratento- rial-associated anomalies.
    [Show full text]
  • Prevalence and Incidence of Rare Diseases: Bibliographic Data
    Number 1 | January 2019 Prevalence and incidence of rare diseases: Bibliographic data Prevalence, incidence or number of published cases listed by diseases (in alphabetical order) www.orpha.net www.orphadata.org If a range of national data is available, the average is Methodology calculated to estimate the worldwide or European prevalence or incidence. When a range of data sources is available, the most Orphanet carries out a systematic survey of literature in recent data source that meets a certain number of quality order to estimate the prevalence and incidence of rare criteria is favoured (registries, meta-analyses, diseases. This study aims to collect new data regarding population-based studies, large cohorts studies). point prevalence, birth prevalence and incidence, and to update already published data according to new For congenital diseases, the prevalence is estimated, so scientific studies or other available data. that: Prevalence = birth prevalence x (patient life This data is presented in the following reports published expectancy/general population life expectancy). biannually: When only incidence data is documented, the prevalence is estimated when possible, so that : • Prevalence, incidence or number of published cases listed by diseases (in alphabetical order); Prevalence = incidence x disease mean duration. • Diseases listed by decreasing prevalence, incidence When neither prevalence nor incidence data is available, or number of published cases; which is the case for very rare diseases, the number of cases or families documented in the medical literature is Data collection provided. A number of different sources are used : Limitations of the study • Registries (RARECARE, EUROCAT, etc) ; The prevalence and incidence data presented in this report are only estimations and cannot be considered to • National/international health institutes and agencies be absolutely correct.
    [Show full text]
  • Orphanet Report Series Rare Diseases Collection
    Marche des Maladies Rares – Alliance Maladies Rares Orphanet Report Series Rare Diseases collection DecemberOctober 2013 2009 List of rare diseases and synonyms Listed in alphabetical order www.orpha.net 20102206 Rare diseases listed in alphabetical order ORPHA ORPHA ORPHA Disease name Disease name Disease name Number Number Number 289157 1-alpha-hydroxylase deficiency 309127 3-hydroxyacyl-CoA dehydrogenase 228384 5q14.3 microdeletion syndrome deficiency 293948 1p21.3 microdeletion syndrome 314655 5q31.3 microdeletion syndrome 939 3-hydroxyisobutyric aciduria 1606 1p36 deletion syndrome 228415 5q35 microduplication syndrome 2616 3M syndrome 250989 1q21.1 microdeletion syndrome 96125 6p subtelomeric deletion syndrome 2616 3-M syndrome 250994 1q21.1 microduplication syndrome 251046 6p22 microdeletion syndrome 293843 3MC syndrome 250999 1q41q42 microdeletion syndrome 96125 6p25 microdeletion syndrome 6 3-methylcrotonylglycinuria 250999 1q41-q42 microdeletion syndrome 99135 6-phosphogluconate dehydrogenase 67046 3-methylglutaconic aciduria type 1 deficiency 238769 1q44 microdeletion syndrome 111 3-methylglutaconic aciduria type 2 13 6-pyruvoyl-tetrahydropterin synthase 976 2,8 dihydroxyadenine urolithiasis deficiency 67047 3-methylglutaconic aciduria type 3 869 2A syndrome 75857 6q terminal deletion 67048 3-methylglutaconic aciduria type 4 79154 2-aminoadipic 2-oxoadipic aciduria 171829 6q16 deletion syndrome 66634 3-methylglutaconic aciduria type 5 19 2-hydroxyglutaric acidemia 251056 6q25 microdeletion syndrome 352328 3-methylglutaconic
    [Show full text]
  • Spectrum of Mutations and Genotype ± Phenotype Analysis in Currarino Syndrome
    European Journal of Human Genetics (2001) 9, 599 ± 605 ã 2001 Nature Publishing Group All rights reserved 1018-4813/01 $15.00 www.nature.com/ejhg ARTICLE Spectrum of mutations and genotype ± phenotype analysis in Currarino syndrome Joachim KoÈchling1, Mohsen Karbasiyan2 and Andre Reis*,2,3 1Department of Pediatric Oncology/Hematology, ChariteÂ, Humboldt University, Berlin, Germany; 2Institute of Human Genetics, ChariteÂ, Humboldt University, Berlin, Germany; 3Institute of Human Genetics, Friedrich- Alexander University Erlangen-NuÈrnberg, Erlangen, Germany The triad of a presacral tumour, sacral agenesis and anorectal malformation constitutes the Currarino syndrome which is caused by dorsal-ventral patterning defects during embryonic development. The syndrome occurs in the majority of patients as an autosomal dominant trait associated with mutations in the homeobox gene HLXB9 which encodes the nuclear protein HB9. However, genotype ± phenotype analyses have been performed only in a few families and there are no reports about the specific impact of HLXB9 mutations on HB9 function. We performed a mutational analysis in 72 individuals from nine families with Currarino syndrome. We identified a total of five HLXB9 mutations, four novel and one known mutation, in four out of four families and one out of five sporadic cases. Highly variable phenotypes and a low penetrance with half of all carriers being clinically asymptomatic were found in three families, whereas affected members of one family showed almost identical phenotypes. However, an obvious genotype ± phenotype correlation was not found. While HLXB9 mutations were diagnosed in 23 patients, no mutation or microdeletion was detected in four sporadic patients with Currarino syndrome. The distribution pattern of here and previously reported HLXB9 mutations indicates mutational predilection sites within exon 1 and the homeobox.
    [Show full text]
  • Mackenzie's Mission Gene & Condition List
    Mackenzie’s Mission Gene & Condition List What conditions are being screened for in Mackenzie’s Mission? Genetic carrier screening offered through this research study has been carefully developed. It is focused on providing people with information about their chance of having children with a severe genetic condition occurring in childhood. The screening is designed to provide genetic information that is relevant and useful, and to minimise uncertain and unclear information. How the conditions and genes are selected The Mackenzie’s Mission reproductive genetic carrier screen currently includes approximately 1300 genes which are associated with about 750 conditions. The reason there are fewer conditions than genes is that some genetic conditions can be caused by changes in more than one gene. The gene list is reviewed regularly. To select the conditions and genes to be screened, a committee comprised of experts in genetics and screening was established including: clinical geneticists, genetic scientists, a genetic pathologist, genetic counsellors, an ethicist and a parent of a child with a genetic condition. The following criteria were developed and are used to select the genes to be included: • Screening the gene is technically possible using currently available technology • The gene is known to cause a genetic condition • The condition affects people in childhood • The condition has a serious impact on a person’s quality of life and/or is life-limiting o For many of the conditions there is no treatment or the treatment is very burdensome for the child and their family. For some conditions very early diagnosis and treatment can make a difference for the child.
    [Show full text]
  • Mackenzie's Mission Gene & Condition List
    Mackenzie’s Mission Gene & Condition List What conditions are being screened for in Mackenzie’s Mission? Genetic carrier screening offered through this research study has been carefully developed. It is focused on providing people with information about their chance of having children with a severe genetic condition occurring in childhood. The screening is designed to provide genetic information that is relevant and useful, and to minimise uncertain and unclear information. How the conditions and genes are selected The Mackenzie’s Mission reproductive genetic carrier screen currently includes approximately 1300 genes which are associated with about 750 conditions. The reason there are fewer conditions than genes is that some genetic conditions can be caused by changes in more than one gene. The gene list is reviewed regularly. To select the conditions and genes to be screened, a committee comprised of experts in genetics and screening was established including: clinical geneticists, genetic scientists, a genetic pathologist, genetic counsellors, an ethicist and a parent of a child with a genetic condition. The following criteria were developed and are used to select the genes to be included: • Screening the gene is technically possible using currently available technology • The gene is known to cause a genetic condition • The condition affects people in childhood • The condition has a serious impact on a person’s quality of life and/or is life-limiting o For many of the conditions there is no treatment or the treatment is very burdensome for the child and their family. For some conditions very early diagnosis and treatment can make a difference for the child.
    [Show full text]
  • Whole Exome Sequencing Gene Package Intellectual Disability, Version 9.1, 31-1-2020
    Whole Exome Sequencing Gene package Intellectual disability, version 9.1, 31-1-2020 Technical information DNA was enriched using Agilent SureSelect DNA + SureSelect OneSeq 300kb CNV Backbone + Human All Exon V7 capture and paired-end sequenced on the Illumina platform (outsourced). The aim is to obtain 10 Giga base pairs per exome with a mapped fraction of 0.99. The average coverage of the exome is ~50x. Duplicate and non-unique reads are excluded. Data are demultiplexed with bcl2fastq Conversion Software from Illumina. Reads are mapped to the genome using the BWA-MEM algorithm (reference: http://bio-bwa.sourceforge.net/). Variant detection is performed by the Genome Analysis Toolkit HaplotypeCaller (reference: http://www.broadinstitute.org/gatk/). The detected variants are filtered and annotated with Cartagenia software and classified with Alamut Visual. It is not excluded that pathogenic mutations are being missed using this technology. At this moment, there is not enough information about the sensitivity of this technique with respect to the detection of deletions and duplications of more than 5 nucleotides and of somatic mosaic mutations (all types of sequence changes). HGNC approved Phenotype description including OMIM phenotype ID(s) OMIM median depth % covered % covered % covered gene symbol gene ID >10x >20x >30x A2ML1 {Otitis media, susceptibility to}, 166760 610627 66 100 100 96 AARS1 Charcot-Marie-Tooth disease, axonal, type 2N, 613287 601065 63 100 97 90 Epileptic encephalopathy, early infantile, 29, 616339 AASS Hyperlysinemia,
    [Show full text]
  • Test Catalogue August 2019
    Test Catalogue August 2019 www.centogene.com/catalogue Table of Contents CENTOGENE CLINICAL DIAGNOSTIC PRODUCTS AND SERVICES › Whole Exome Testing 4 › Whole Genome Testing 5 › Genome wide CNV Analysis 5 › Somatic Mutation Analyses 5 › Biomarker Testing, Biochemical Testing 6 › Prenatal Testing 7 › Additional Services 7 › Metabolic Diseases 9 - 21 › Neurological Diseases 23 - 47 › Ophthalmological Diseases 49 - 55 › Ear, Nose and Throat Diseases 57 - 61 › Bone, Skin and Immune Diseases 63 - 73 › Cardiological Diseases 75 - 79 › Vascular Diseases 81 - 82 › Liver, Kidney and Endocrinological Diseases 83 - 89 › Reproductive Genetics 91 › Haematological Diseases 93 - 96 › Malformation and/or Retardation Syndromes 97 - 107 › Oncogenetics 109 - 113 ® › CentoXome - Sequencing targeting exonic regions of ~20.000 genes Test Test name Description code CentoXome® Solo Medical interpretation/report of WES findings for index 50029 CentoXome® Solo - Variants Raw data; fastQ, BAM, Vcf files along with variant annotated file in xls format for index 50028 CentoXome® Solo - with CNV Medical interpretation/report of WES including CNV findings for index 50103 Medical interpretation/report of WES in index, package including genome wide analyses of structural/ CentoXome® Solo - with sWGS 50104 large CNVs through sWGS Medical interpretation/report of WES in index, package including genome wide analyses of structural/ CentoXome® Solo - with aCGH 750k 50122 large CNVs through 750k microarray Medical interpretation/report of WES in index, package including genome
    [Show full text]